This proposed project is a longitudinal study of the behavioral, attitudinal, and socioeconomic correlates of oral health outcomes in community-dwelling dentate older adults. The aim of this project is to develop a risk assessment model of longitudinal oral health outcomes in high-risk dentate populations. Of special interest will be the influence that demand for specific dental services has on oral health outcomes. As well as quantifying a range of risk factors from an interdisciplinary perspective, a major effort of this project will be the assessment of a broad range of oral health outcomes. These outcomes will not only include clinical measures of oral diseases and conditions, but will also quantifY non-disease-based outcomes; i.e., oral signs, oral symptoms, oral functional impairments, and psychosocial impacts of oral disease. High- risk groups of special interest will be African-Americans, residents of rural areas, residents of low income households, and persons with infrequent dental care use. To ensure that adequate comparisons can be made of high-risk and low-risk individuals for risk assessment model development, a multi stage disproportionate sampling approach has been used. Telephone screenings have been used to identifY 3,998 persons who are 45 years old or older, reside in one of 4 counties of interest, and are dentate. These eligible subjects so identified were then stratified based on age, race, residence, and household income, and a sample of 900 persons is being selected randomly within strata for further study. To gather baseline data on the hypothesized risk factors and the oral health outcomes, these 900 subjects are participating for an interviewer- administered questionnaire and clinical examination. This proposed project will assess this panel of 900 persons periodically over the following 48-months after their baseline measurements. This research will improve our understanding of the natural history of oral health outcomes (oral signs, symptoms, functional impairments, and psychosocial impacts, as well as oral diseases and conditions), the risk factors for these outcomes, why high-risk persons seek or do not seek dental care for these specific outcomes, and what benefits (or decrements) are derived from this care.